Jellinek Curve of Addiction

A classic tool with present-day usefulness

Can a simple infographic developed six decades ago still be helpful to alcoholics and addicts today?The Jellinek Curve, created by E. Morton Jellinek, and later revised by Max Glatt, is a chart that describes the typical phases of alcoholism and recovery.

E. Morton Jellinek is one of the fathers of the science of alcoholism. He managed the Carnegie Project for the Research Council on the Problems of Alcohol (RCPA) in 1939, and then worked with the Yale Center for Alcohol Research in the 1940s and 50s. He may be best known for his 1960 book The Disease Concept of Alcoholism. The Jellinek Curve took shape on the basis of two now-controversial surveys and the papers he wrote about them, including 1952's "Phases of Alcohol Addiction."

Jellinek's work attempted to identify the progressive stages of alcoholism: from early social drinking through phases that included constant relief drinking, physical deterioration, and finally the admission of complete defeat and the chronic, seemingly unending vicious circles of obsessive drinking (seen in the chart below).

Later in the 50s, British psychiatrist Max Glatt, founder of the Alcohol Treatment Unit at Warlingham Park Hospital in England, developed the "up" side of the curve based on his observations of the typical pattern of recovery among patients he served. The combined graph is the one we know today as the Jellinek Curve.

Bob Poznanovich, author of of It's Not Okay to Be a Cannibal—How to Stop Addiction from Eating Your Family Alive and executive director of National Outreach and Business Development at the Hazelden Betty Ford Foundation, has found the Jellinek Curve to be a useful tool—both in his own recovery from addiction, and when talking about the need for recovery with those considering addiction treatment for themselves or their loved ones.

When talking to individuals and family members, Poznanovich says, "I ask them to self-select where they think they or their loved one is at on this curve, where they think they'll be if they don't get help, and how long they think it will take to get there. We don't want it to get any worse. Wherever they're at in that curve is as low as they have to go. That first call for help, that first reaching out. It's easier and less expensive to treat somebody when they're at the top of that curve than when they're at the bottom."

The point is to help those who are considering the need for recovery to quickly see both that their path is not unusual and that there's much more to lose along the way. Many people have followed the same downward trajectory through the common phases of alcoholism and other drug addiction. With the help of the Jellinek Curve, someone can quickly see what they have lost so far and what they are likely to lose next if they continue to use.

Still, many seeing the curve for the first time will have to admit they've already reached the bottom. Those already stuck in the vicious circle of obsessive using may wrongly conclude that there's no reason to stop since they have already lost everything.

Poznanovich wants them to understand there is one critical thing not mentioned on the chart: "If you spin around at the bottom too long, you die prematurely. So one thing I always say is that death isn't on this chart. You can fall out of the funnel and die. But the hope is that somebody doesn't have to get to the point where they're in that vicious circle before they ask for help, or before those who have the power to intervene do so."

"This is the predictable path. It could be made worse by the consequences that will follow: legal, medical, spiritual, financial. It's all in there. Then jail, institutions, death. All of that is the predictable consequence of using."

The chart helps people with addictions understand the promise of dependency. The real power of the chart, though, may be that it also points to what is possible with the hope of recovery.

What has been lost can be regained. The path can be reversed. Just as there is a typical downward path, there is also a typical upward path for those in recovery.

"People often think that it's just about stopping the drinking," Poznanovich says, "but that's not what recovery is about. Recovery is the upside. As it says [on the upper right side of the chart]: an 'enlightened and interesting way of life opens up, with a road ahead to higher levels than ever before.' The ultimate goal is: not only do I get to avoid the spiral of the obsession which will lead to a premature death, but I get to go on a road that could help me be better and happier than I was before I even started drinking."

"That gap is in the middle, right?" Poznanovich says. "Where am I at, and where do I want to be? And what I'm working on is closing that gap. Your life could get worse than you believed possible. And your life could get better than you believed possible. But if you don't get help, you'll get worse."

"It's easier and cheaper to treat somebody when they're at the top of that curve than when they're at the bottom."

The Hazelden Betty Ford Foundation is a force of healing and hope for individuals, families and
communities affected by addiction to alcohol and other drugs. It is the nation's largest
nonprofit treatment provider, with a legacy that began in 1949 and includes the 1982 founding
of the Betty Ford Center. With 17 sites in California, Minnesota, Oregon, Illinois, New York,
Florida, Massachusetts, Colorado and Texas, the Foundation offers prevention and recovery
solutions nationwide and across the entire continuum of care for youth and adults.